Member Consultant - Healthcare/ Medical Aids

Job Purpose

Provide an effective and efficient conduit between the Company and its clients (i.e. members and appointed representatives of the organisation) through provision of advice, query resolution, administrative service, communication, training and education.

Key Responsibilities

• Demonstrate a good understanding of the Employee Benefits (medical scheme, retirement fund, group risk, employee wellness programme, expatriation health benefits etc.) industry and the products available in the market;
• Conduct in-depth analysis of members’ financial needs and provide appropriate advice, record, save onto the CRM and provide member with a copy of the record of advice;
• Ensure that members understand the benefits, exclusions, administration processes and procedures of their appointed schemes/funds;
• Advise members who are leaving their employers (retirement/resignations) of their options (e.g. continuation, transfers, preservations options, tax implications, etc.) and refer them to an authorised financial planner for advice;
• Consult with members who have low investment (e.g. Red zone) to encourage them to increase their contributions or change their investment strategy;
• Conduct and arrange onsite member assist sessions, inductions, and training sessions. Ensure meeting notes are sent out for these engagements.
• Assist with resolve outstanding requirements for new business applications in the event the AC department was unable to resolve after 3 attempts.
• Yearend review presentations or where there is an open window period when required

ADMINISTRATION AND QUERY MANAGEMENT

• Attend to the resolution of members and/or employer queries. You are required to escalate complex queries to your senior consultant as soon as possible;
• Save client communication on internal drive, keep record of attendance register for training sessions, on-site session, queries received and option change forms;
• Prepare meeting packs for trustees/committee, record and distribute meeting notes to all relevant parties;
• Request necessary data/information from schemes/funds to support projects;
• Assist with resolution of billing discrepancies, membership compliance audits;
• Provide the Human Resource and Payroll team of each client in your portfolio with monthly dashboard report/stats of all activities and analysis relevant to you scope of responsibilities.
• Provide day to day assistance for general queries and updates on claims from members and HR
• Submit withdrawal, funeral, death, disability claims for processing
• Designing members newsletters with fund information
• Dispatching of benefit statements
• Preparation of member booklets, presentations, and fund summary reports for all employer groups
• Assist HR with updated claim forms upon request
• Governance – Ensure that all fund documents are saved on the Drive
• Persuade members to buy additional products to maximise their benefits (e.g. Vitality, Gap Cover, etc.)

Qualifications

• Matric, FAIS Fit & Proper compliant (NQF Level 5, Regulatory Exams)
• 3 years’ experience in medical insurance

Competencies

• Written and verbal communication skills in English
• Customer Focus
• Attention to details
• Deadline driven